help me stay asleep
October 30, 2019 12:44 PM   Subscribe

So I'm in the middle of an external situation that is filling me with dread and stress. One of the ways this is affecting me is that I wake up between 2-3 am, "fight or flight" reflexes blazing. I generally don't have trouble falling asleep -- often I'm exhausted and fall asleep easily -- but after about 4 hours I'm done. I haven't had a full night of sleep in weeks and it's starting to affect me badly. Anyone have tricks for staying asleep?

Things I have tried:

1. "parking" the worries verbally before going to bed by verbalizing them and telling myself it will be ok. (It may not be ok, actually.)
2. exercise early in the day -- this helps me get to sleep but does not help the "staying asleep" issue
3. magnesium -- just started taking this on a friend's recommendation -- has not helped yet
4. white noise
5. drink/sleeping pill/valium before bed: none of these keep me down for the night.

Anecdata welcome. I'm at my wits' end.
posted by fingersandtoes to Health & Fitness (43 answers total) 23 users marked this as a favorite
Go to bed earlier. When you wake up, get up; do something.

After a little while, let yourself drift back to sleep.
posted by notsnot at 12:48 PM on October 30, 2019 [2 favorites]

Soft sleep headphones and something I find poetic but not gripping, on a timer. _Wind in the Willows_ or _Spinning Silver_ or some ASMR recordings, to go back to sleep with.

... never have figured out how to not wake at all, sorry.
posted by clew at 12:52 PM on October 30, 2019

What do you do when you wake up in the night?
posted by purpleclover at 12:54 PM on October 30, 2019

I struggle with this as well in times of stress and it is hell. If you can tolerate melatonin tablets that has been the most effective thing I have found to get me through a whole night without waking up, while still being able to get up in the morning and function.

Otherwise it helps to have an audio book or relaxation tape loaded up on my phone next to the bed that I can pick up and listen to without much thought. Anything relaxing but engrossing enough to break the panicking unhelpful thought spiral. I try to avoid turning the lights on or looking at too bright a screen, reading a kindle with the brightness dialled right down is ok.

Otherwise a good dose of antihistamine before bed but that is a last resort for me. Best of luck, it is a horrid cycle to get into.
posted by arha at 12:57 PM on October 30, 2019 [3 favorites]

I had some luck with valerian capsules a while back when I was having some trouble sleeping. One side effect - dreams got very vivid and cinematic. Also, er, valerian smells like feet when you open the bottle.
posted by jquinby at 12:58 PM on October 30, 2019 [2 favorites]

I lie there and try to think calm thoughts. When this fails (it always fails, I'm not going to do it anymore) I give up and go to the other room so I can read on my ipad (night mode) without disturbing my husband. I read until my eyes are tired and I generally fall asleep again as morning approaches.
posted by fingersandtoes at 12:58 PM on October 30, 2019 [1 favorite]

For me, one of the things that wakes me up without fail about the same time is temperature regulation. As in, I wake up because I feel too hot. If the temperature is right, I will usually go at least six hours straight. So, maybe try bringing the temperature in your bedroom down a few notches and see if that helps.

Every sleep expert (including my partner, who runs a sleep clinic...) will probably tell you this is wrong, but... I also find I sleep better when I've done some work before bedtime and stayed up until I'm tired rather than going to bed at 9/10 p.m. I might have less sleep opportunity going to bed at midnight and having to be up at six, but I will usually sleep straight through if I work on something before bedtime.
posted by jzb at 12:58 PM on October 30, 2019 [1 favorite]

I deal with this a lot, but it's been better recently. I attribute it to anxiety. What I think has helped:
- I take a small dose of klonopin every night (i know you tried valium, but i dunno if a different benzo may be more effective)
- I try to do something "mindless" right before bed (usually video games, looking at cute/interesting photos on the internet)
- I try to allot a 9 hour window for sleep so if I end up waking up I have a buffer to get another sleep cycle in.
- If I'm laying in bed for like, more than an hour, I get up and just do stuff and usually end up sleepy and go back to bed.
- I'm in therapy for anxiety, which has improved.
posted by disaster77 at 12:59 PM on October 30, 2019 [1 favorite]

There are many guided meditations/anxiety hypnosis vids on YouTube -- I pop on one of those and listen using headphones. I know it's just a recording, but having a human voice reassure me before dropping off has helped keep me asleep.
posted by apparently at 1:03 PM on October 30, 2019 [1 favorite]

I literally just finished, like, 24 hours ago, a proofread of a book by a sleep medicine doc about cognitive behavioral therapy for insomnia. There were a bunch of steps related to people who wake at night and can't get back to sleep, but one thing that was stressed was what a few people mentioned, doing something mindless away from the bed until you're well and truly sleepy (not physically exhausted, but sleepy). Another thing that might relate to your particular situation was making a worry log, where you write down the things that are causing you stress in one column, and what you can do about them in another, and then keep that anxiety focused on the page. Let it go, it's out of your hands and on the paper.
posted by kitten kaboodle at 1:05 PM on October 30, 2019 [7 favorites]

Sometimes when I can't go back to sleep, it's because I am hungry. A handful of nuts or a chunk of cheese can make me settle back down.
posted by Duffington at 1:11 PM on October 30, 2019 [2 favorites]

I use the Calm app and put on a sleep story as soon as I wake up, with sleep headphones. I am allergic to guided meditations but's very relaxing to have someone read one a story. I fall back asleep 19 out of 20 times.

Alternatively, if you do not have money to throw at this, my library membership includes the Libby app and I put on some Sherlock Holmes for 30 minutes.
posted by DarlingBri at 1:15 PM on October 30, 2019 [4 favorites]

I have often had this exact experience. I find that making a list of problems and things I can do to solve them/keep them under control before I go to bed helps a little. Sometimes I still wake up. When I wake up, I find I can fall asleep again pretty easily if I stay in bed with the lights off and listen to someone reading a story, like the New Yorker's "The Writer's Voice" podcast. This keeps my mind occupied and focused on something other than worrying until my sleepy body takes over again.
posted by frau_grubach at 1:16 PM on October 30, 2019

If you have access to it, I fixed my 4am-ish wakefulness issue with a fairly strong CBD oil sublingual spray. I still sorrrrrrrrrrt of wake up, I think, because it's part of my sleeping rhythms, but my brain doesn't turn on at that time, which was always my problem. I use this one.
posted by urbanlenny at 1:17 PM on October 30, 2019 [2 favorites]

Also here to recommend some soothing audio, in my case The Empty Bowl (yes, a podcast about cereal), and even if I can't get back to sleep I feel a little more relaxed. (White noise used to work for me in a different phase of my life, but I find that just a little bit of narrative is better, then if I'm awake still at least I'm enjoying the audio.)
posted by epersonae at 1:19 PM on October 30, 2019 [2 favorites]

What do you do when you wake up in the night?

This is the crucial question.

A quick Google search on sleep cycles will show you that at several times during the night, your sleep gets very shallow. Waking at one of those times is normal and can be expected if your sleep is overall more shallow due to stress.

So the question really is -- what is making it harder to fall back asleep after waking? First, just understanding that waking is "normal" and doesn't necessarily mean you'll have to stay awake, that you can indeed fall back asleep, can help. Second, are your physical needs met? It can be harder to recognize them straight after waking, and they can keep you up until you recognize and address them. Third, what's your plan / ritual for sleep initiation? Have a plan ahead of time and follow through, so you don't have to create a plan at 3am, which is stressful.

When I wake in the middle of the night, I pee, I drink a bit of water, and I eat just a small bit, just to make sure the physical needs are met. I stay as dark as possible (no screens, obv). Then I'll re-initiate the sleep ritual: dark, warm enough, comfortable, breath deep and slow, have a contest of not moving, visualize a walk through a forest. This usually works (and i am otherwise NOT a good sleeper). But it also helps just to know: waking is natural, not the End Of Sleep.

Working with this natural cycle is a better first approach than focusing on must-sleep-all-night-through.
posted by Dashy at 1:26 PM on October 30, 2019 [8 favorites]

For the past week I've been switching on the Sleep With Me podcast as soon as I wake up in the middle of the night. I don't even know what the podcast is actually like yet because every night I have fallen asleep a few minutes after the intro has finished. I queue up 2 or 3 episodes to make sure they keep playing in case I wake up again, and even though I haven't been doing this for more than a few days, it's been magical! I even feel more refreshed after the podcast-assisted chunk of sleep than I normally do after falling back asleep again, but that could just be confirmation bias.

YMMV, but try it out if you can.
posted by phatkitten at 1:28 PM on October 30, 2019 [6 favorites]

B complex vitamins help to keep me asleep.
posted by notyou at 1:36 PM on October 30, 2019

I am also having the worst time staying asleep lately. The only suggestion I have is to avoid drinking before bed (I think this can actually worsen sleep) and I would avoid the sleeping pills or other medicine if you can fall asleep without them. I do sometimes take diphenhydramine, the over the counter medicine found in Benadryl (sold as a sleep aid in the drugstore), if I wake up at 2am. Yoga before bed does seem to help me a little bit- this video is good. She also has a routine for middle of the night waking.
posted by pinochiette at 1:37 PM on October 30, 2019

This has been my last five months or so. I finally went to see a guy about it to make sure it’s not a thyroid thing or whatever (nope). He had some decent sleep hygiene advice — and the patient education he offered he is really similar to what Dashy said above, so let me second all of that — but he also said to me, basically, based on your medical history, when you fall apart this is what happens; for you, there’s no way out but through, so let’s work on through. You’ll know if this is true of you (it really rang true for me).

It actually has gotten better for me this fall as I’ve tried to come to terms with my own source of dread over which I have limited personal control, and nowadays I just spend a bunch of my waking time thinking, ok, this is life now, this shitty thing is probably going to happen to someone I care about, so how do we make the best of it? I don’t know if this will work for you; you might be better served plowing a ton of energy into fixing the thing, or avoiding the thing, or whatever. Or it might be such an existential thing that there is not really any reconciling yourself to it. I don’t know. But I think this process, for me, has been more important than the sleep hygiene.
posted by eirias at 2:20 PM on October 30, 2019 [2 favorites]

This is a problem I'm all too familiar with! I'll describe my own approach to the problem, in the hope that it will work for you too.

If I wake up at night, it's best if I can prevent the "anxiety spiral" from getting started. I do this by attempting to distract myself with old episodes of radio comedy. I enjoy listening to these, but because I know them well already they don't hold my attention, and so I often drift off to sleep.

But ... suppose the anxiety spiral does start, what then?

In this case, in my experience, the radio comedy won't help: the anxious thoughts are powerful enough to push through into consciousness even if I am listening to radio comedy. So what I do in this case is get out of bed, go downstairs, and meditate. I usually find that twenty minutes or half an hour of meditation is sufficient to halt the anxiety spiral, at which point I can go to bed. Once in bed, I turn on radio comedy to prevent the anxiety spiral from re-starting.

If you haven't meditated before, and want advice, you could message me ... or read one of the many ask metafilter threads on the topic!
posted by HoraceH at 2:25 PM on October 30, 2019

I am in the melatonin camp. I haven't used anything special -- just the Trader Joe's version -- but I find a huge difference when I take it vs. when I don't. I may still wake up, but I'm able to easily fall back asleep with it.
posted by BlahLaLa at 2:26 PM on October 30, 2019 [1 favorite]

In this situation I usually do 2 things: firstly, listen to audiobooks or podcasts, on the dronier, more boring side of things. Nothing with loud noises or laughter. Science or history usually does it.

The second is to keep reminding myself that it’s quite nice to be in a nice cosy bed, when I don’t have to get up yet, and nobody is expecting anything of me. Visualising an alternative sometimes helps - eg I tell myself “imagine being outside on a cold rainy night or out on a boat in a turbulent sea, instead of here in bed”. That’s taken years of sleepless nights to perfect - but practising does make it more effective to get to a place where I can actually sort of enjoy being awake but lazy.
posted by JJZByBffqU at 2:26 PM on October 30, 2019 [3 favorites]

A small meal usually does it for me.
posted by Tell Me No Lies at 2:28 PM on October 30, 2019

I had this for years, 3-4 nights a week. Then I finally did sleep restriction therapy (google it, it's part of CBT-I), and for the last couple of months I've been sleeping through the night. There's a good explanation of it in here. I found the "estimate how long you were awake" part too inaccurate, so I bought a sleep tracker to do that for me. The first two weeks were fairly rough, but the reduction in stress from being awake for hours in the middle of the night was worth it. Good luck.
posted by Jobst at 2:36 PM on October 30, 2019 [1 favorite]

YMMV but I've dealt with this kind of insomnia in the worst way this entire year (along with severe depression) and the sleep and depression started reinforcing each other in a terrible cycle.

I'm starting to come out of it (cross your fingers) and what helped me was (a) talking to my psychiatrist and getting on anti-depressants; (b) lots of therapy to address the underlying issues; and (c) an occasional sleeping pill taken when I woke up in the middle of the night.

Now the depression issues might not be relevant to you (but have a serious think about if they are, because very often this kind of insomnia is a symptom). But even so I think (c) might help you. My psychiatrist suggested it. He said you don't want to over-rely on sleeping pills -- so I've never taken one more than two nights in a row -- but they can help snap you out of a bad cycle where being overtired makes the mood/anxiety worse and thus makes you more likely to sleep badly the next night. And that is exactly what I've found has happened. I was worried that taking a sleeping pill so late would make me groggy the next morning, but it's made me no groggier than missing so much sleep would, and indeed if I take it before 2:30am or so there are no obvious effects at all.

Like I said, YMMV, but it may be worth considering.
posted by forza at 3:04 PM on October 30, 2019 [1 favorite]

I’ve been struggling through some significant external stress for the last few years and my approach is to just lay there with my eyes shut and try not worry about getting actual "sleep". I find that if I keep my eyes closed and picture my brain laying in a hammock, it's still a valuable form of rest. I’ll be less tired in the morning than I'd be if I got up or started surfing the net. I try to be grateful that I can just lay there. There's still a chance I may nod off but I try not to make that the goal.

I've found the a Tylenol works if I'm feeling uncomfortable.
posted by bonobothegreat at 3:23 PM on October 30, 2019

I find lying on the sofa under a blanket reading a physical book better for falling back to sleep than using a screen. Browsing the internet, even on night mode, guarantees being up for hours. My theory is that the effort involved in reading an extended text makes you sleepy, plus it's better not having the light shining right in your eyes. The instant sleepiness strikes, back to bed!
posted by ogorki at 4:28 PM on October 30, 2019 [1 favorite]

It sounds like you're having a bad episode with anxiety and/or depression, and that's disrupting your sleep. I have severe chronic insomnia which, unmedicated, follows your pattern reasonably closely.

Here's what I do:

Ambien XR. The regular stuff doesn't cut it, but the extended release helps.
Antidepressant du jour
posted by bile and syntax at 5:10 PM on October 30, 2019

(c) an occasional sleeping pill taken when I woke up in the middle of the night.

This really helped me with the same issue. I think the big thing was breaking the cycle -- before, waking up meant staying awake, which then becomes it's own awful cycle of worry ("oh no, I've woken up, now I will be exhausted all day...").

With the prescription pills available, waking up just means taking one, listening to a boring audiobook for a little bit, and going back to sleep, instead of staying awake and stressing. For me, taking away the stress from the awakening has resulted in having it happen less often. This is over and above all the usual stuff about "sleep hygiene," melatonin, avoiding caffeine, and so on -- you need that as the baseline, but that alone wasn't enough for me to change the pattern.
posted by Dip Flash at 5:16 PM on October 30, 2019

Make sure you're not being jolted awake by your blood sugar plummeting (that happened to me for a while). Having a light, but protein-packed snack, like a handful of pumpkin seeds or almonds or a couple sticks of string cheese, helped.

In addition to melatonin, CBD, and soothing podcasts, what really helps me sleep soundly through the night is: 1) a weighted blanket (it really made a difference!) and 2) magnesium. Pumpkin seeds, again, are rich in magnesium, but you can also take a preparation like Natural Calm.
posted by Rosie M. Banks at 5:34 PM on October 30, 2019

I'm not clear on whether the situation is causing dread and stress because it is really literally dangerous and potentially calamitous, or only extremely aggravating and frustrating and socially unfair.

I have had some cases of the latter and what eventually got me out of the middle of the night panics was comparing each day what I had predicted would happen, to what actually happened. Somehow in the middle of the night my mind manufactured scenarios that were far worse than what actually happened the next day (though certainly not a walk in the park).

So I eventually conditioned myself that when I woke and started thinking about work I would just scrunch my pillow up, tell myself that I would be better able to deal with whatever did come my way if I am well rested, take some deep breaths and then go back to sleep. YMMV & FWIW.
posted by forthright at 7:05 PM on October 30, 2019

Lemon balm and chamomile supplements from a reputable brand can help, as can glycine (tastes sweet, easily mixable in water, 3-5 grams is the general dosage 1 hour before bedtime. Obviously IANYD, so check with your doc before adding supplements. I can also offer you a few things that work for me that aren't drug related: A biurnal beat sleep video that runs for 9 hours. You can also find something similar on Amazon, and it works best with headphones. This noise generator has sliders so you can adjust what works for you. If you donate, you can get a download of your customized track (haven't done that in a long time so). Also works best with headphones. Finally, if you can acordian fold a weighted sleep throw or sleep blanket between you and your partner, you can pull it over you when you wake up. All of these things have improved my ability to get back to sleep.
posted by Issithe at 7:10 PM on October 30, 2019

6th-ing melatonin.

I hate sleeping pills. They are basically muscle relaxants for me, so I feel like my body is crushed, but my brain is still whheeeeeee! Never again.

Melatonin is a natural hormone and has a really light touch. It doesn't so much put you to sleep, rather help you stay asleep through that critical 4-5 hour point where you might wake up.

5 mg is a typical dose and is what I use when jet-lagged after traveling internationally and I need to sleep through the night in a new time zone. I also use it weekly on Sunday nights when I need to get back on a weekday schedule, after a weekend of sleeping in.
posted by intermod at 7:28 PM on October 30, 2019

thank you all, I will get some melatonin ASAP and go through the other suggestions soon as well.
posted by fingersandtoes at 7:42 PM on October 30, 2019

Ymmv, but I personally find melatonin + magnesium work best to keep me asleep when dealing with stress (or just general sleeplessness).

It may be a good idea to try the melatonin alone first (knocks my husband out all night long), but if that's not quite getting you there try the two together.
posted by ghost phoneme at 8:21 PM on October 30, 2019

those of you who've recommended a sleeping pill taken upon waking in the night: what sleeping pill do you use? are we talking ambien or, like, Advil PM?
posted by fingersandtoes at 8:36 PM on October 30, 2019

If you are drinking alcohol in the evenings, try cutting that out. As I've gotten older, my body has decided that even 1 or 2 drinks will invariably lead to a 4 am wakeup call.
posted by somanyamys at 7:32 AM on October 31, 2019 [1 favorite]

I have had good luck with this: ZZQuil

I tend to wake in the night if I have sore/achy joints or worked out earlier, so on nights when I feel that may happen, about 30-40 minutes pre-sleeptime, I take Tylenol and half a dose of ZZQuil (just one caplet vs. the 2 in the standard dose). This has worked very well for me, and only taking half a dose makes them last longer and keeps me from being too groggy in the morning.
posted by I_Love_Bananas at 8:59 AM on October 31, 2019

I was waking up at 2am for months on end, and being awake for anywhere from 2-4 hours, just ruminating on life without any specific stressors. I tried melatonin, knockoff Tylenol PM, benadryl, etc., which would work for a night or two at the most and then not work again. I mentioned it to my doctor at my last physical and he asked how I felt the next day -- was I still functioning pretty well? I was (except for the nights I was awake midnight-6am instead of 2am-6am) and he suggested that it was possible that I just don't really need that much sleep and I should start going to bed later. I pushed back my bedtime from 10:30-ish until closer to midnight and this problem almost entirely went away, and it happened immediately.
posted by jabes at 1:09 PM on October 31, 2019

Someone recently suggested to me for my own nighttime hypervigilence to stand up near the bed in the dark. It helps you realize how tired you are.

Yoga nidra is also potentially helpful as it forces you to redirect your attention to sensations vs thoughts.
posted by crunchy potato at 2:23 PM on October 31, 2019

Indica Berry by Enjoy Cannabis Co puts me under and keeps me there until my alarm goes off. Context: extremely light sleeper, bad anxiety woke me up at 4-5 am daily, history of insomnia.
posted by moons in june at 5:03 PM on October 31, 2019 [1 favorite]

I have Generalized Anxiety Disorder but hadn't taken daily medication for it for years because I couldn't tolerate the side effects of SSRIs/SNRIs. I was having a really stressful time earlier this year and found a great psychiatrist who prescribed an old antidepressant called Remeron. It's not technically a sleeping pill but it knocks me out around an hour after taking it and I sleep through the night, rarely even waking up to use the bathroom.

Also on the non-medication front, ditto sleep stories, soothing podcasts, etc—they give my brain just enough to latch on to so I can turn off.
posted by radioamy at 10:06 PM on November 2, 2019

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